Hossein Hodjati; Hamed Ghoddusi Johari; Bizhan Khademi; Abdolkarim Rahmanian; Abtin Vahidi; Maryam Dehghankhalili
Volume 7, Issue 4 , October 2019, , Pages 420-423
Abstract
The aneurysms of the extracranial segment of the internal carotid artery are not common and are associated with severe neurologic deficits. They could be misdiagnosed with several lesion of the cervical region. We herein report a case of internal carotid artery aneurysm misdiagnosed as paraganglioma. ...
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The aneurysms of the extracranial segment of the internal carotid artery are not common and are associated with severe neurologic deficits. They could be misdiagnosed with several lesion of the cervical region. We herein report a case of internal carotid artery aneurysm misdiagnosed as paraganglioma. A 23-year-old man presented with progressive growing mass in right enlarging mass in the upper part of the neck below the angle of the mandible. The patient underwent surgery by the ear, nose, throat (ENT) surgeon through submandibular approach with impression of paraganglioma but severe pulsatile bleeding was encountered intraoperatively. Two vascular clamps were applied and the patient was transferred to the vascular ward. Computerized tomography (CT) angiogram revealed a huge aneurysm of the internal carotid artery in the extracranial segment with injured wall. After 2 days of medical therapy the patient was transferred to the operating room and the aneurysm was repaired using Dacrons. The patient had an uneventful hospital course and was asymptomatic after 1 year of follow-up. Precise preoperative assessment and evaluation with different modalities should be performed to avoid fatal complications. Surgery is a safe and effective method in experienced hands for repair of such aneurysms.
Hossein Hodjati; Sahar Sohrabi Nazari; Seifollah Dehghani Nazhvani; Mohammad Yasin Karami; Bita Geramizadeh
Volume 5, Issue 3 , July 2017, , Pages 160-164
Abstract
Objective: To evaluate the efficacy of the gallbladder for reconstruction of the inferior vena cava in a canine model.Methods: The experimental study was conducted on 5 dogs; an oval window with a diameter of (4×1 cm) was made in the inferior vena cava and then repaired using the autologous gallbladder ...
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Objective: To evaluate the efficacy of the gallbladder for reconstruction of the inferior vena cava in a canine model.Methods: The experimental study was conducted on 5 dogs; an oval window with a diameter of (4×1 cm) was made in the inferior vena cava and then repaired using the autologous gallbladder patch with preservation of gallbladder function. The patency and functionality of the graft were assessed macroscopically and microscopically at 2 months postoperatively.Results: All the dogs were euthanized at 2 months, showing excellent patency of the vena cava macroscopically. In the microscopic examination, all the patches were completely endothelialized. No evidence of infection and inflammation and thrombosis was noted.Conclusion: The gallbladder patch is an available and safe alternate for reconstruction of the inferior vena cava at least in animal model. However, further well designed prospective studies are needed to confirm this hypothesis.
Hossein Hodjati; Ahmad Hoseinzadeh; Seyed Masoud Mousavi; Seifollah Dehghani Nazhavi; Viginda Kumar; Maryam Sehhatpour
Volume 5, Issue 1 , January 2017, , Pages 24-28
Abstract
Objective: To evaluate the feasibility and results of using serosal patch of small bowel for repair and replacement of inferior vena cava (IVC) after resection of a part of infra-renal IVC in an animal model, as it may be encountered in extensive tumors of retroperitoneal and trauma patients.Methods: ...
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Objective: To evaluate the feasibility and results of using serosal patch of small bowel for repair and replacement of inferior vena cava (IVC) after resection of a part of infra-renal IVC in an animal model, as it may be encountered in extensive tumors of retroperitoneal and trauma patients.Methods: Five healthy sheep of both sexes were prepared. After general anesthesia and laparotomy, a defect with 1 cm width and 4cm length was made on anterior aspect of infra-renal IVC, and then an adjacent loop of small bowel was brought and sutured continuously to cover the defect of IVC as a patch graft. The observation period was two months.Results: Three of five IVCs were macroscopically patent without stenosis and thrombosis. Pathologic assay revealed complete endothelialization of serosal surface of the patch of small bowel loop. One of IVCs was completely occluded in gross evaluation and fibrous formation in pathologist review. The sheep had no sign of venous hypertension and edema of limbs. One sheep died at the night of first operation due to internal bleeding.Conclusion: Serosal patch of small bowel is an accessible and feasible alternative in repair and reconstruction of IVC especially when there is restriction for use of prosthetic material in a contaminated space of abdomen.
Hossein Hodjati; Parviz Mardani; Masoud Mousavi; Ahmad Hoseinzadeh; Sajjad Ahmadi; Sahar Sohrabi; Alireza Golchini
Volume 3, Issue 3 , July 2015, , Pages 111-113
Abstract
Traumatic injuries to great vessels are relative common in trauma practice. Blunt thoracic trauma may result in dissection injury to aorta and innominate artery. We herein present a late presentation of traumatic innominate artery aneurysm. A29-year-old woman presented with dyspnea to our emergency department. ...
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Traumatic injuries to great vessels are relative common in trauma practice. Blunt thoracic trauma may result in dissection injury to aorta and innominate artery. We herein present a late presentation of traumatic innominate artery aneurysm. A29-year-old woman presented with dyspnea to our emergency department. She had previous motor-vehicle accident a month before presentation for which had undergone chest tube insertion. She was diagnosed to have traumatic aneurysm of innominate artery resulting in tracheal stenosis resulting in acute life threatening respiratory failure. She underwent simultaneous aneurysm resection and tracheal reconstruction. She was uneventfully discharged from hospital. Any post-traumatic respiratory and cardiovascular symptoms may propound an undiagnosed serious injury to the great vessels. Extra and repetitive imaging studies may help us in better evaluation of traumatized patients with high energy mechanisms and sharp injuries to chest and neck.
